Health Insurance Blog

Seniors seem to love Medicare Advantage Plans.  In some areas, such as South Florida, 40% of seniors aged 65+ have enrolled in these plans for those eligible for Medicare. Nationally about 22% of seniors are enrolled in Medicare Advantage plans.

It isn’t hard to see why these plans are popular, many Medicare Advantage plans require members to pay no monthly premiums in addition to no deductibles or co-pays to see their doctors.

However, Medicare Advantage plans may become collateral damage of health care reform which is primarily focused on addressing the nations uninsured.  President Obama seeks to cut $177 Billion in federal payments to private health plans over the next decade in order to finance his plan for health care reform.  A large portion of these cuts to payments to private health plans will likely be in subsidies for Medicare Advantage Plans, which at the very least could mean a reduction in benefits and/or increased monthly premiums required by members.

In November of 2008, we published a series of posts breaking down the US News and report’s rankings of commercial health plans. Similarly, below are their rankings of the top Medicare health plans for 2008 based on the same criteria (consumer assessment, prevention, treatment).

1. Preferred Care
2. Kaiser Foundation Health Plan of Southern California
3. Geisinger Health Plan
4. Blue Cross Blue Shield of Massachusetts
5. Security Health Plan of Wisconsin
6. Blue Cross Blue Shield of Rhode Island
7. Capital Health Plan
8. Kaiser Foundation Health Plan of Colorado
9. Capital District Physicians Health Plan
10. Tufts Associated HMO

More inforamtion about health plans for seniors, Medicare advantage plans, and traditional Medicare Supplement Plans.

According to the PRWeb article through medicaresupplementplans.com entitled “California Health Insurance Assistance Program Awarded 2009 Grant Funding”, California health insurance assistance programs are expected to receive about $3 million in grants to help Medicare beneficiaries in need of information on health insurance topics.

This is an ongoing effort to better assist these citizens who are often lacking comprehensive and accurate information about their health care options.  The funds being used are part of a $35.8 million grant from the Centers for Medicare and Medicaid Services.  The grants to California health insurance assistance programs are part of the 1st installment of funding that began in April ‘09 and will end in March ‘10.

Seniors often underestimate how time consuming researching and understanding their benefits can be.  And sometimes it gets really complicated.  These funds will support programs designed to make this process for them a little easier.  The assistance is personalized and local while providing a wide range of health insurance information best suited to each individual.

According to an article written by Robert Pear of the New York Times, broad consensus among the Democrats on the redeployment of our country’s health care system is not far off.

Democratic leaders in both houses said they would indeed make health insurance mandatory, requiring  individuals to carry health insurance coverage and employers to help pay for it.  The question is, how will they raise the necessary tax revenue to support it?  On way that has been discussed is taxing employer health benefits.

In addition to making health insurance compulsary, the bill outlines yesterday would allow people to enroll in a governement run health plan similar to Medicare.  There are other suggestion being floated by Senate Democrats that would limit the scope of Government involvement, but would still create a plan to compete with private health insurance companies via a “Co-op”.

According to Reuters, below is a list and description of the key players involved in the health care debate and subsequently shaping health care reform

• Kathleen Sebelius, Health and Human Services Secretary, leads Obama’s push to enact by the end of 2009 an overhaul of the $2.5 trillion U.S. health care industry. Previously served as the Kansas health insurance commissioner for eight years.
• Nancy-Ann DeParle, director of White House Office of Health Reform, is charged with coordinating reform efforts with Congress. A former Clinton administration official, DeParle headed the Health Care Financing Administration (now Centers for Medicare & Medicaid Services).
• Rahm Emanuel, White House Chief of Staff.   He was chairman of the House Democratic Caucus, fourth in the hierarchy of House Democratic leaders, was formerly a senior adviser to President Clinton.
• Senate Finance Committee Chairman Max Baucus, and the panel’s senior Republican, Sen. Chuck Grassley have taken the lead in the debate, playing key roles in writing legislation aimed at reducing soaring costs and expanding health insurance coverage to the estimated 46 million uninsured Americans.
• Senate Health Committee Chairman Edward Kennedy, has been a leader in the Senate on health care reform, pushing for a Patient’s Bill of Rights and an expansion of Medicare, to lower prescription drugs cost.
• Sen. Mike Enzi of Wyoming, senior Republican on the Senate Health panel, advocates for bipartisan support for health care reform.
• House Energy and Commerce committee chairman Henry Waxman, has championed reform efforts, including expand of health coverage for children, seniors, persons with disabilities, and low-income families.
• Joe Barton, the senior Republican on the House Energy panel, says ensuring that Americans are able to afford the health care they need is an important priority.
• House Ways and Means chairman Charles Rangel, supports an expansion of health care to include Americans who lack health insurance coverage. He says the United States must provide health coverage for children and working people the same kind of coverage Medicare provides for Seniors.
• Rep Dave Camp, the senior Republican on the House Ways and Means panel, says health coverage expansion can and should be done without making the government the sole health insurance provider.

More coveage of health care reform topics.

A recent Reuters article quoted these facts about our healthcare system.

1. According to US Government economists, public and private health care spending will hit $2.5 Trillion this year, 17.6% of GDP
2. Americans spend more per capita on health care than any other country at $7,421 per person, and receive poorer care than many other industrialized countries that have nationalized health care.  (Of the $7000 plus spent on health care per person…35% of this is paid by private health insurance companies, 19% paid by Medicare, 15% is paid by Medicaid and Children’s Health Insurance Programs, 12% from public funds, 7% private sources, and the remaining 12% out of pocket by patients.)
3. 15% of population (46 million people) have no health insurance coverage.
4. 63% of US companies offer health benefits to workers.
5. Growth in health insurance premiums has outpaced workers’ earnings and inflation since 2004 by a ratio of 4 to1.

The Dow Jones News Service reports in the Minneapolis Star-Tribune that the Center for Medicare and Medicaid Services is planning on limiting out-of-pocket charges and plans under private Medicare Advantage insurance. The Obama administration has announced plans to enact cost-sharing limits; patients will pay less for certain treatments, including:

• home nursing services/home health care
• renal dialysis
• selected prescription drugs

In addition, the number of Medicare Advantage plans on the market will be limited in order to reduce consumer confusion. CMS claims that a quarter of all Medicare Advantage programs have fewer than 10 people enrolled!

Insurers, such as UnitedHealth Secure Horizons, state that they have expected reductions in health insurance rates under Medicare Advantage and will adapt through benefit modifications and cost management.

After April 1, Medicare beneficiaries will be locked into their current plan through the remainder of 2009.  If you are enrolled in a Medicare health plan and unhappy with it, don’t procrastinate shopping for a new plan.

According to Paul Precht from the Medicare rights Center, below are the changes that can be made before April 1.

• A Senior who is enrolled in a Medicare private health plan with drug coverage (like an HMO or PPO) can switch to another Medicare plan that also offers drug coverage. They can also switch to “original Medicare” with a stand-alone drug plan.
• If someone has original Medicare with a stand-alone drug plan, they can switch to a Medicare private health plan with drug coverage. However, they cannot,  add or drop the Medicare drug benefit (Part D) and they cannot switch from one stand-alone prescription drug plan to another one. Most people with Medicare will not be able to change their health plan again until 2010.

More information about senior health insurance options

New details have been released regarding Blue Cross Blue Shield of Michigan’s plans for rate hikes. The insurer is requesting that the Michigan Office of Financial and Insurance Regulation allow them to increase their premiums. Changes BCBSM is requesting would have an impact on many people

• Individual health insurance policies would be, on average, 56% more expensive.
• An average cost increase of 31% would hit seniors with Medicare supplements.
• Group conversion plans, which are for individuals transitioning out of employer-sponsored coverage, would be set to increase by 42%.

The top four providers of Florida health insurance recently met to discuss health care under a Barack Obama administration, says Jeremy Cox of the Jacksonville Times-Union. Representatives from Humana, UnitedHealth, Blue Cross Blue Shield of Florida, and Aetna were in attendance.

The insurers believe that President Obama should enact a health insurance mandate for all Americans if, as they predict, he will require insurers to cover individuals with pre-existing conditions. They think that the cost will be prohibitive for carriers otherwise. At the moment, Obama has not publicly supported a mandate, and how exactly one would be carried out is unknown. He has supported a role for the private sector in universal health care, but that role will most likely be a change from the current market.

Instead of the plans Obama and congressional Democrats have proposed for health care reform, the insurance companies would prefer that the government focus mainly on enrolling eligible but currently uninsured individuals in federal-run programs like Medicaid and Medicare, Jeremy says. While the insurance companies agreed that greater coverage is a priority, they claim the task of covering other Americans should be left to them through innovative new plans.